Periodontal Status of Renal Transplant Patients Receiving Immunosuppressive Therapy

P, Schuller; Freedman, Harvey L.; Lewis, Don W.

doi:10.1902/jop.1973.44.3.167

Cited by 54 publications

(21 citation statements)

References 14 publications

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“…This effect was detected regardless of high plaque levels in the transplant and hemodialysis patients. Our observations are in accord with the findings of SCHULLER et al [8], BEEN AND ENGEL [9]. KARDACHI et al [23] and to some extent with ROBERTSON et al [24,25] However, some investigators have found no significant difference in plaque index, gingival index or periodontal index scores among patients on IS drug therapy, patients on hemodialysis and systemically healthy individuals, indicating that IS drugs do not affect the clinical appearance of periodontal disease [11][12][13][14]26].…”

Section: Discussionsupporting

confidence: 92%

“…On the other hand, several studies have revealed a beneficial role of the immune response in protecting against or limiting bacterial infection [5-71. Studies of renal transplant patients receiving immunosuppressive (IS) drug therapy have shown that these individuals have considerably less periodontal inflamma tion [8][9][10]. However, it has also been reported that there is no significant difference in periodontal breakdown between renal transplant patients and matched healthy controls [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

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Periodontal Health Parameters in Patients with Chronic Renal Failure and Renal Transplants Receiving Immunosuppressive Therapy.

Mustahsen

Çağlayan

Rahman

1992

The Journal of Nihon University School of Dentistry

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The periodontal status of 54 renal transplant recipients and 52 patients with chronic renal failure receiving hemodialysis was evaluated and compared with that of systemically healthy subjects matched for age, sex, social status and the number of teeth present. The renal transplant recipients had been receiving immunosuppressive (IS) drug therapy since the time of transplantation. Both of the renal patient groups had significantly higher plaque index scores than the respective controls. By contrast, the renal transplant recipients showed significantly lower periodontal scores and pocket depths. However, there was no significant difference between the hemodialysis group and the corresponding healthy controls with regard to mean periodontal index score and pocket depth. No significant differences could be found among the three groups with regard to mean sulcular bleeding index score or gingival index score. Within the IS group, no relationship was found between the duration of drug therapy and the various periodontal parameters. The observed variations among the groups studied appear to suggest modulation of periodontal condition by both general health status in patients with chronic renal failure and the IS agents used in renal transplant recipients.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Periodontal Health Parameters in Patients with Chronic Renal Failure and Renal Transplants Receiving Immunosuppressive Therapy.

Mustahsen

Çağlayan

Rahman

1992

The Journal of Nihon University School of Dentistry

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“…Some of these drugs were found to have effects on the periodontal tissue, effects that could decrease 8 or increase 9,10 the cellular response of gingival and periodontal tissue to periodontal disease.…”

Section: Introductionmentioning

confidence: 99%

Is there a relationship between periodontal conditions and number of medications among the elderly?

Natto¹,

Aladmawy²,

Alshaeri³

et al. 2016

Ghana Medical Journal

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SUMMARYObjective: To investigate possible correlations of clinical attachment level and pocket depth with number of medications in elderly individuals. Methods: Intra-oral examinations for 139 patients visiting Tufts dental clinic were done. Periodontal assessments were performed with a manual UNC-15 periodontal probe to measure probing depth (PD) and clinical attachment level (CAL) at 6 sites. Complete lists of patients' medications were obtained during the examinations. Statistical analysis involved Kruskal-Wallis, chi square and multivariate logistic regression analyses. Results: Age and health status attained statistical significance (p< 0.05), in contingency table analysis with number of medications. Number of medications had an effect on CAL: increased attachment loss was observed when 4 or more medications were being taken by the patient. Number of medications did not have any effect on periodontal PD. In multivariate logistic regression analysis, 6 or more medications had a higher risk of attachment loss (>3mm) when compared to the no-medication group, in crude OR (1.20, 95% CI:0.22-6.64), and age adjusted (OR=1.16, 95% CI:0.21-6.45), but not with the multivariate model (OR=0.71, 95% CI:0.11-4.39). Conclusion: CAL seems to be more sensitive to the number of medications taken, when compared to PD. However, it is not possible to discriminate at exactly what number of drug combinations the breakdown in CAL will happen. We need to do further analysis, including more subjects, to understand the possible synergistic mechanisms for different drug and periodontal responses.

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“…Individuals suffering from primary lymphocyte disorders, such as hereditary deficiencies in cell-mediated immunity, exhibit less gingival inflammation than do normal individuals, with no indication of periodontitis of greater severity than that of normal individuals (Robertson et al, 1978;Robertson et al, 1980). Similarly, organ transplant patients whose lymphocytes are suppressed by azathioprine and prednisone show little difference in periodontal disease as compared with that in age-, sex-, and plaque-matched controls (Schuller et al, 1973;Kardachi and Newcomb, 1978;Tollefsen et al, 1978;Oshrain et al, 1983;Sutton and Smales, 1983).…”

mentioning

confidence: 99%

1985 Kreshover lecture. Molecular Factors Influencing Neutrophil Defects in Periodontal Disease

et al. 1986

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Major advances in our understanding of the role of the neutrophil in host defense against periodontal organisms have been made through studies of localized juvenile periodontitis (LJP). Several lines of evidence suggest that LJP is an infectious process closely associated with Actinobacillus (Haemophilus) actinomycetemomitans as a causative agent, although other organisms may also participate. The immunologic profile of LJP patients suggests that a cell-associated neutrophil locomotory dysfunction is a key underlying immunodeficiency resulting in increased susceptibility to periodontal infection. In addition, LJP patients often exhibit cervical lymphadenopathy and IgG-hypergammaglobulinemia, and a markedly elevated antibody response to the infecting organism, A. actinomycetemcomitans, is found in the serum and crevicular fluid of most patients. Evaluation of the locomotory properties of LJP neutrophils shows that random migration and chemokinesis are normal; however, about 70% of the LJP patients suffer from a defect in chemotaxis, with their neutrophils responding poorly to bacterial chemotactic factors, synthetic chemotactic peptides, and complement fragments (C5a). Depressed chemotaxis of LJP neutrophils is paralleled by their reduced capacity to bind the synthetic chemotactic peptide N-formylmethionylleucylphenylalanine (FMLP), as well as C5a. Furthermore, there is a reduction in the amount of glycoprotein 110, a neutrophil membrane matrix component and differentiation antigen which is associated with FMLP- and possibly also C5a-mediated chemotaxis. Reduction of C5a and of FMLP ligand binding, decreased expression of GP-110, and reduced neutrophil chemotaxis are consistent with a stem cell maturation error in LJP patients. This is further supported by studies demonstrating increased expression of CR2, the C3d/EBV receptor, on peripheral blood neutrophils of LJP patients. CR2 receptors are normally present on immature human neutrophils but are lost during the maturation process. These alterations in neutrophil surface components and their reduced chemotaxis may result from a genetically determined abnormality. Studies demonstrating the familial nature of both the neutrophil chemotactic disorder and the clinical entity represented by localized juvenile periodontitis point to a strong role for genetic determinants in the disease which affect neutrophil surface receptors.

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Periodontal Status of Renal Transplant Patients Receiving Immunosuppressive Therapy

Cited by 54 publications

References 14 publications

Periodontal Health Parameters in Patients with Chronic Renal Failure and Renal Transplants Receiving Immunosuppressive Therapy.

Periodontal Health Parameters in Patients with Chronic Renal Failure and Renal Transplants Receiving Immunosuppressive Therapy.

Is there a relationship between periodontal conditions and number of medications among the elderly?

1985 Kreshover lecture. Molecular Factors Influencing Neutrophil Defects in Periodontal Disease

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